在宫颈病变诊断中应用阴道镜检查的效果分析

Analysis of the effect of colposcopy in the diagnosis of cervical lesions

目的探究在宫颈癌前病变及宫颈癌诊断中应用阴道镜检查的效果。方法138例疑似宫颈病变患者,将宫颈液基细胞学检查(TCT)正常、人乳头瘤病毒(HPV)高危型阳性的患者作为A组(80例),将TCT诊断为意义不明确的非典型鳞状细胞(ASC-US)、HPV高危型阳性的患者作为B组(58例),两组均进行阴道镜检查+活检。观察和比较两组患者阴道镜检查+活检的癌前病变及宫颈癌检出情况。结果A组80例TCT正常的患者中,阴道镜检查提示高度鳞状上皮内病变(HSIL)8例,低度鳞状上皮内病变(LSIL)45例;活检证实HSIL 10例,LSIL 43例,宫颈病变的检出率为66.25%(53/80),阴道镜准确率为87.78%。B组TCT诊断为ASC-US的58例患者中,提示HSIL 11例,LSIL 39例;活检证实HSIL 14例,LSIL 40例,宫颈病变的检出率为86.21%(50/58),且阴道镜准确率为88.04%。两组阴道镜准确率比较,差异均无统计学意义(P>0.05)。结论在宫颈癌前病变及宫颈癌诊断中,相比较单纯用TCT和HPV检查,采用阴道镜检查可明显提高宫颈病变的检出率,而癌前病变检出率的提高尤为重要,为临床诊断宫颈癌前病变及宫颈癌提供重要参考。

Objective To investigate the effect of colposcopy in the diagnosis of cervical precancerous lesions and cervical cancer.Methods In 138 patients with suspected cervical lesions,patients with normal thinprep cytology test(TCT)and high-risk human papillomavirus(HPV)positive were classified as group A(80 cases),and patients with TCT diagnosed as atypical squamous cells of undetermined significance(ASC-US)and positive high-risk HPV were classified as group B(58 cases),and both groups were subjected to colposcopy+biopsy.The detection of precancerous lesions and cervical cancer by colposcopy and biopsy were observed and compared between the two groups.Results Among 80 patients with normal TCT in group A,8 cases were positive for high-grade squamous intraepithelial lesion(HSIL),45 cases were low-grade squamous intraepithelial lesion(LSIL),10 cases were confirmed by biopsy and 43 cases by LSIL.The detection rate of cervical lesions was 66.25%(53/80)and the accuracy rate of colposcopy was 87.78%.Among 58 patients diagnosed as ASC-US by TCT in group B,11 cases were positive for HSIL,39 cases were LSIL,14 cases were confirmed by biopsy and 40 cases by LSIL.The detection rate of cervical lesions was 86.21%(50/58),and the accuracy rate of colposcopy was 88.04%.There was no significant difference in colposcopy accuracy between the two groups(P>0.05).Conclusion In the diagnosis of cervical precancerous lesions and cervical cancer,colposcopy can significantly improve the detection rate of cervical lesions compared with TCT and HPV alone,and the improvement of detection rate of precancerous lesions is particularly important,which provides an important reference for clinical diagnosis of cervical precancerous lesions and cervical cancer.